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Hip Pain at Night? Here are a Few Reasons Why

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EmpowHER has heard from many people who experience hip pain at night. They wake up in the morning in pain, or are awakened during the night from pain and have difficulty getting back to sleep.

While each person will have a specific reason why they experience pain and should be properly diagnosed, in general we have found several conditions that can cause this discomfort.

This condition causes cartilage in joints to disintegrate. Cartilage provides a kind of cushion between various bones, and when the cartilage weakens the bones can rub together causing great pain and inflammation.

The hips are commonly affected, along with other joints. Hip pain at night is common for many reasons. Osteoarthritis pain flares due to inactivity. It is often at its worst first thing in the morning. Lying on an affected hip all night can increase the pain.

Treatments for osteoarthritis include:

Over-the-counter pain medication
Acetaminophen (e.g., Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (e.g., Advil) and naproxen (e.g., Aleve)
Prescription Pain Relief Medication
Arthrotec — NSAID that may reduce the risk for gastrointestinal bleeding
Opiates and opiate-like medications
Viscosupplementation — injection of a substance called hyaluronan into the joint, which helps lubricate the joint
Pain relief creams — capsaicin , methyl salicylate and menthol

Dietary Supplements
There is some evidence that glucosamine and chondroitin may relieve pain and/or decrease osteoarthritis progression. Talk with your doctor before taking any herbs and supplements.

Alternative Treatments
Some doctors report that acupuncture has been successful in reducing the pain of osteoarthritis, although the evidence is not consistent.

While more studies are needed, balneotherapy (hot water therapy), relaxation therapy, exercise, yoga and tai chi may be helpful.'

Mechanical Aids
Shoes, splints or braces, canes, crutches walkers and orthopedic shoes also can help those with advanced osteoarthritis in the lower body.

Weight Reduction
Losing weight can lessen the stress on joints affected by osteoarthritis. Losing five pounds can eliminate at least 15 pounds of stressful impact for each step taken. The more weight lost, the greater the benefit.

Exercise and Physical Therapy
Swimming and water aerobics are good options because they don't put stress on the joint.

You can read a lot more information here: https://www.empowher.com/condition/osteoarthritis/treatments/

Bursitis is another condition that causes hip pain at night. Bursitis is caused the bursa (tissue that protects tendons) becomes inflamed, causing pain.

Bursitis is most commonly seen in the knees, elbows, shoulders and hips. Symptoms for hip bursitis include pain in the area, swelling and an inability to move the joint well.

Treatment includes:

Resting the affected area
Icing the painful area
Taking anti-inflammatory medications
Having a cortisone injection
Protecting the area from trauma

Treatment for chronic bursitis may include:

Stopping the activity causing pain
Taking anti-inflammatory medications
Protecting the bursa from trauma
Having physical therapy, including exercising and applying heat
Having a cortisone injection
Undergoing surgery

More can be explored here: https://www.empowher.com/condition/bursitis/treatments/

The symptoms of sciatica are generally shooting pains through the back, deep into pelvis and legs, affecting the hips along the way. The sciatic nerve is located in the spine and can often be exacerbated by inactivity, including being in bed for the night.

Symptoms include:

Burning, tingling, or a shooting pain down the back of one leg. Pain in one leg or buttock that is worse with:

Standing up
Weakness or numbness in a leg or foot

These symptoms affect the hips. A doctor will need to examine the hips, as well as the back and legs in order to form a diagnosis.

Treatment includes limited physical activity.

Prolonged bedrest is usually not advised. However, your doctor may recommend resting in bed for 1-2 days.

Too much bed rest can weaken muscles and slow healing. Doctors generally recommend staying active within the limits of your pain and avoiding activities that worsen back pain.

Medications used to treat sciatica include:

Pain relievers, such as acetaminophen , aspirin , or ibuprofen
Muscle relaxers for muscle spasm
Cortisone pills or injections where the sciatic nerve comes out of the spine
Antidepressants for chronic pain

Physical Therapy
These alternative therapies have not been proven by scientific studies to have an effect on sciatica. However, some people may find some pain relief from the following:


Surgery may be done to relieve pressure on the sciatic nerve. This is performed in emergency situations or if conservative treatments fail. Common surgical procedures are microdiskectomy and lumbar laminectomy.

Talk to your doctor about the right treatment plan for you.

Read up on sciatica here: https://www.empowher.com/condition/sciatica/treatments/

EmpowHER also has a very lively and informative thread that discusses hip pain that worsens at night. To read the experiences and diagnoses or others or to post your own story, click here: https://www.empowher.com/community/ask/hip-pain-middle-night-dull-ache-w...

While the information above discusses various causes of hip pain at night, anyone with hip pain needs to see their own doctor for a full evaluation and diagnosis.

Reviewed February 15, 2012
by Michele Blacksberg RN
Edited by Jody Smith

Add a Comment2 Comments

Very nice article. It was very comprehensive. In my practice, I find that sometimes people get confused by where their hip is. When we are speaking about the hip medically, it means the hip joint which is the head of the femur and the acetabulum. Sometimes patients come in with pain at the iliac crest, which they think is the hip. That type of pain is usually a biomechanical/musculoskeletal problem, which chiropractic care and possibly massage therapy is perfect for.

If the cause is osteoarthritis, bursitis, or other things mentioned in the article, this may be the long time accumulation of abnormal biomechanical stresses that lead to some of the symptoms mentioned.

I frequently get this response when a patient comes in with hip pain on one side, but not the other, and they tell me, "My doctor says it's old age." I facetiously ask, "OK, how old is the other hip?" My point being is that some biomechanical issue that caused asymmetrical stress and therefore wear on the hip joint caused that problem. It may be helped by mechanical aids, like shoes, walkers, orthotics, etc. If you rely on a walker, a cane or other aid, I'm a firm believe in "use it or lose it." If you have to use a walking aid, hopefully it's only temporary, or you may develop a dependence on it, which can permanently alter your biomechanical movement pattern.

The point of biomechanics is very similar to the alignment on a tire. If the tire is putting more stress on one side of the tire, and the stress is not uniformly distributed, the tire will wear unevenly. That's just common sense. A similar process happens in our bodies with uneven biomechanical processes, your MD, or orthopedic surgeon will likely give you a similar explanation, but limited treatment options including medication, injections, surgery and maybe PT, which all may help, but usually not the first choice of patients.

For side sleepers, I usually recommend putting a pillow between your knees to prevent asymmetry.

Sometimes surgery may be necessary, if the hip pain has degenerated too far, before that, many of the remedies mentioned in the article may be effective for symptom relief. Although I don't do them myself, under some circumstances, I recommend that a patient may see an orthopedic surgeon about a possible cortisone injection. That is not a first choice as it's a fairly invasive treatment (most people don't want needles), but after conservative treatment is attempted, and not successful, may be an option to calm the area down, then resume with functional treatment, i.e., chiropractic. Physical therapy or a personal trainer may be helpful after the biomechanical/functional problem has been addressed and muscle weaknesses still need to be addressed.

Even though acupuncture was mentioned as a possible alternative therapy, which may be effective for pain, chiropractic care was not mentioned, but can be very effective in mobilizing and improving the function of the hip and lower extremity.

Modern chiropractic care and/or massage therapy may be helpful for many of the biomechanical issues mentioned above including bursitis, osteoarthritis, tendonitis, sciatica and many other conditions that are likely due to abnormal biomechanical function, asymmetry, tight muscles, etc. Chiropractic can help to restore movement and function that allows those painful areas to better distribute stress, like I mentioned earlier in the misaligned tire example.
A good chiropractor can help you know what your options are because chiropractic care is a good option if your problem is not surgical, but painful enough to require treatment. Not all chiropractors are the same, however, modern chiropractic may be a valid option for some.

February 16, 2012 - 10:48am

Interesting article, thank you. I suffer occasional bouts of hip pain. Being a side sleeper, I have found that sometimes, for no reason I can think of, my hip will be sore to lie on. Sleeping on the other side doesn't help much either. When it happens it will usually last a couple of days and it painful no matter what I do, stand, sit, lay down. I don't believe it is osteoarthritis as there are no other symptoms and it's so sporadic that it happens. On the other hand, I do deal with sciatica several times a year, but have not noticed that my hip is ever affected by it. The last bout was just last week and surprisingly lasted only 36 hours instead of the usual 3-4 days. I can say though, that this getting old stuff has got to go.............LOL

February 15, 2012 - 1:48pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.